Women at Risk for Mental Illness Forgo Cancer Screenings

Women aged 40 to 74 who suffer from serious psychological distress are far less likely to get a breast exam, a mammogram or a Pap test, a new study finds.

Women have unique risks for certain gender-specific forms of cancer, as well as prominent risks for certain forms of cancer also found in men. Participation in regular, age-appropriate screening procedures can significantly reduce the odds that any given woman will die from cancer. In a study published in late 2014 in the journal Women’s Health Issues, researchers from the University of Illinois at Urbana-Champaign looked at the impact of serious psychological distress (SPD) on middle-aged and older women’s likelihood of getting regular cancer screenings. SPD is one of the known risk indicators for the onset of diagnosable mental illness.

Women and Cancer

According to figures compiled by the American Cancer Society, women in the U.S. develop skin cancer and breast cancer more often than any other form of cancer. Five additional malignancies most likely to occur in women are colon and/or rectal cancer, ovarian cancer, cancer of the uterine lining (endometrial cancer) and lung cancer. In most cases, older women have higher cancer risks than their younger counterparts. However, age is not a strict determinant of any given woman’s odds of developing problems.

Broadly speaking, the best way to avoid the life-threatening complications associated with cancer is to catch malignant changes in normal tissue as quickly as possible. Doctors have developed screening procedures specifically designed to detect certain types of cancer. Examples of these procedures include physical breast exams and mammograms designed to detect breast cancer, Pap tests designed to detect cervical cancer and endometrial biopsies designed to detect endometrial cancer. The appropriate age for initiating regular screening can vary widely depending on the form of cancer in question. For example, breast cancer screenings typically begin when a woman reaches her 20s and ideally become a yearly event when a woman reaches her 40s.

Serious Psychological Distress

Serious psychological distress is a term that mental health experts and public health officials use to describe a level of constant or recurring mental/emotional stress that starts to impair a person’s ability to function normally or feel a sense of daily well-being. The presence of SPD is not the same as a diagnosis for a specific mental illness. However, an affected individual has clearly heightened chances of developing symptoms that qualify him or her for such a diagnosis. Figures compiled by the federal Substance Abuse and Mental Health Services Administration indicate that roughly 11 percent of all Americans over the age of 17 develop serious psychological distress in any given year. Unfortunately, less than half of all affected individuals seek treatment for their at-risk mental/emotional state.

Impact on Women’s Cancer Screenings

In the study published in Women’s Health Issues, the University of Illinois researchers used data gathered from a federal project called the Medical Expenditure Panel Survey to gauge the impact of serious psychological distress on the odds that women between the ages of 40 and 74 will take part in recommended screenings for breast cancer and cervical cancer. A total of 17,770 women in the target age range responded to the survey in the years under consideration (2007-2011). The researchers used a mental health tool called the Kessler Psychological Distress Scale to measure each woman’s level of exposure to SPD. They also compared the rates of participation in three common cancer screening procedures—a physical breast exam, a mammogram and a Pap test—among women affected by SPD and women unaffected by this indicator of declining mental health.

The researchers concluded that the presence of serious psychological distress significantly diminishes the odds that a woman between the ages of 40 and 74 will get a breast exam, a mammogram or a Pap test. The greatest disparity between women with SPD and women unaffected by SPD occurs in mammogram participation; just 60 percent of women with serious psychological distress get an appropriate mammogram, compared to almost 76 percent of women unaffected by serious psychological distress. When the three screening procedures are considered together, women with SPD have an almost 40 percent lower overall rate of participation than women without SPD.

The study’s authors note that several factors increase the odds that a woman dealing with serious psychological distress will keep up with appropriate cancer screenings. These factors include regularly receiving healthcare at the same facility, visiting the doctor’s office multiple times per year and maintaining regular participation in exercise or other forms of physical activity.

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